Antibiotic exposure not a risk factor for coeliac disease in children
Prenatal or postnatal antibiotic exposure does not contribute to an increased risk of developing coeliac disease (CD) in children, according to a recent study.
Researchers conducted a systematic review of studies in which either women during any trimester of pregnancy or infants and young children underwent intravenous or oral antibiotic treatment if the exposure preceded the CD diagnosis. A total of six studies were included.
All studies evaluated the exposure to any antibiotics, while specific types of antibiotics such as penicillins, cephalosporins and macrolides were considered only in three studies. One study provided specific data about early (≤17 weeks of pregnancy) and late (pregnancy week ≥18 until delivery) pregnancy. For postnatal exposure, the age at antibiotic exposure ranged from birth to 4 years.
In the large Norwegian and Swedish cohorts that evaluated prenatal antibiotic exposure, no association with the risk of CD was found (adjusted odds ratio [OR], 1.16, 95 percent CI, 0.94–1.43 and adjusted hazards ratio [HR], 1.33, 0.69–2.56, respectively).
On the other hand, the results were contradictory in three studies that explored the association between postnatal antibiotic exposure and the risk of CD, with only the Italian cohort study reporting a significant positive association (adjusted incidence rate ratio, 1.24, 1.07–1.43).
Finally, a large multicentre cohort study that evaluated the association between postnatal antibiotic exposure and CD autoimmunity in human leukocyte antigen (HLA)-positive subjects showed null results.
Additional investigation is still needed to elucidate the effects of antibiotic use or underlying infections, or both, on the development of CD/CD autoimmunity, the researchers said.